Residents Accuse Alameda Hospital of “Dangerous Incompetence”

September 20th, 2010

Denise Lai, an Alameda resident, says that she went to the Alameda Hospital Emergency Room on a Sunday morning in extreme pain earlier this year, and almost didn’t come out alive. She’s started a Facebook page to encourage people to share their own stories – good or bad – about Alameda Hospital.

Ms. Lai says that the medical staff there failed to follow procedures for administering a narcotic (for the pain) and allowed her to languish for three hours with dangerously low blood pressure, and that the Emergency Room doctor’s written report was full of errors, describing her as a child who had arrived with a parent. She is a married middle-aged adult who arrived at the ER with her husband. She says that the ER physician sent her home with “the wrong and insufficient cocktail to be able to maintain my own at home,” and ended up in worse pain than when she was first seen, and that subsequently, she was taken to Alta Bates Hospital for treatment. She says she feels morally obligated to both alert people to the hazards that may exist at the hospital and to learn more: she believes there may be more stories like hers.

Lai told Action Alameda News, “When I went to emergency room at our local Alameda Hospital this summer, every single team failed, and it nearly cost me my life. It was very serious. Since then every single person I talk to has had their own personal nightmare at the hospital. Every single story details problems from substandard medical services that, like my experience, crosses all teams and exacerbates their suffering. I have been frustrated that no one in Alameda talks about the hospital; had these friends and neighbors told me their stories [earlier], I would never have gone to the local hospital nor would I have been subjected to the unnecessary pain and agony I experienced that day. So I started a Facebook page for sharing our stories, good and bad (but I haven’t heard a good one yet) so that we can all be better informed. My very real concern is that the hospital is so poorly run that it is a dangerous medical facility. It certainly was the day I went there. People should know this fact so that they make better decisions about their healthcare providers and protect themselves.”

Indeed, there are more stories like Denise Lai’s. On her Facebook page, Dennis Green of Alameda wrote, “I had been taken to Alameda Hospital for years, but the last time, when I was so potassium deficient I was in shock, the nurses, as I was transferred from the E.R. up to the floors, were injecting the potassium too quickly. At first, it just burned, then it seemed to be boiling in my veins. I kept complaining, for I knew from previous experiences, what was wrong. They ignored me. It got so bad, I lapsed into a seizure. I could have had a stroke, or even died from this extreme state.” (Action Alameda News has confirmed Mr. Green’s story with him.) Other people have contributed their stories to the Facebook page as well.

Thank you for your inquiry. Alameda Hospital takes all complaints seriously and we encourage our patients to provide us feedback, both positive and negative. Our mission is to provide quality and personalized care to our patients and every complaint is seen as an opportunity to improve the care we provide.

Our patients have a variety of avenues to voice concerns and we encourage them to utilize these avenues to provide us feedback. Patients can contact Hospital Administration (814-4000) or the Director of Quality and Resource Management (814-4036). Every complaint brought to the attention of Hospital management allows us to review, investigate, and respond in a timely manner. Unacceptable care can also be reported to the California Department of Public Health (1-800-554-0352), or Joint Commission’s Office of Quality Monitoring (1-800-994-6610, e-mail: complaint@jcaho.org).

Alameda Hospital’s comprehensive Performance Improvement Program provides a framework to continually improve clinical outcomes, operational performance, safety and patient satisfaction. Patient feedback has led to improvements in processes and systems throughout the Hospital. While I’m not able to comment on specific patient complaints, I can assure you that the District Board of Directors, Hospital management, medical staff, and our employees are dedicated to hospital-wide quality improvement.

Quality of care and patient safety are the fiduciary responsibilities of the City of Alameda Health Care District Board of Directors. The Board Quality Committee meets regularly to review continuous improvement data and assure that the measurements, assessments and improvements are consistent with the Hospital’s mission, vision and values.

Like hospitals across the country, Alameda Hospital is working diligently to reduce medical errors by utilizing best practice or evidence based medicine. Our improvement activities are ongoing and evaluated frequently. This allows us to identify initiatives and develop processes that improve performance of both hospital and medical staff. Clearly, the Hospital’s goal is to serve the community effectively, and we are committed to providing safe and quality care to our patients. I want to hear from our patients and members of the community about the care and service we provide.

We also asked Alameda Hospital about the purpose of their recent presentation to the Alameda City Council. The Hospital has it’s own governing body, the The City of Alameda Health Care District Board. Was the presentation a media opportunity for the District in anticipation of future parcel taxes to support the Hospital? (The Health Care District currently raises about $6 million from Alameda property owners through a parcel tax.)

Louise Nakada, Director of Community Relations for the Alameda Hospital responded, “And, yes, you are right, Alameda Hospital has its own governing body. The presentation to the City Council was simply an update about the current status of Alameda Hospital. Open communication with the City is essential as we will be working with the City during our seismic retrofit project and other new program development. I also want to assure you that we have no intention of asking the public for another parcel tax.”

Alameda City Council Candidates Lena Tam and Marilyn Ezzy Ashcraft are past members of the Health Care District Board; City Council candidate Rob Bonta is a sitting member of the board.

Besides being a “Frequent Inmate,” I’ve worked in healthcare marketing for many years, and know how critical reputation is to a hospital’s survival. Kaiser, for example, surveys patient satisfaction continuously, every time you have a exam or procedure. I’ve had few problems there, but have complained loudly when I have. You have to be your own patient care advocate, and make a fuss when things don’t go well.

All hospitals also have to pass official inspection of their facilities, staffing and patient files, so your complaint must be filed officially to protect others. Too bad that Facebook has the be the way that Alameda Hospital learns it has a problem!

I haven’t met a single person who said they’d return to the ER. One person said they’d had an accident where there was a broken femur; before deciding where to go for their emergency, they phoned around to find out which orthopedic surgeon was in the hospital that day, on call. They vetted that surgeon via their network of friends, and did go to Alameda Hospital (nearest hospital when in intense pain) and the surgeon did a perfect job. But they knew WHO they were seeing prior to arriving AND they had the surgeon’s work checked by experts at Stanford to make sure no errors were made that would cause future problems. This is something that very few residents can do for themselves to ensure they get optimum care locally. Hospitals, particularly emergency rooms, are supposed to provide a minimum standard of care so that they are 1. reliable, 2. safe, and 3. properly address the acute and/or traumatic condition to RELIEVE the patient.

Well, DHL, you haven’t met me! I’d return to the ER if needed, as would my wife. We’ve both been hospitalized in the past and the standard of care was excellent. Perhaps you’re not aware that Alameda Hospital is among the best in the country for cardiac care as noted in the July 2010 issue of the US News and World Report, which recognized it as one of America’s BEST hospitals.

The American Heart Association and American Stroke Association’s Get With The Guidelines – Coronary Artery Disease Gold Performance Achievement Award is also a reflection of the Hospital’s success in providing a higher standard of cardiac care that effectively improves the treatment of patients with heart disease. Hospitals that receive the Gold Performance Award consistently implement appropriate evidence-based care and protocols to reduce the number of recurrent events and deaths in cardiovascular disease patients.
Alameda Hospital’s commitment to excellence is ongoing. For the fourth year in a row, Alameda Hospital has received NATIONAL recognition for clinical excellence in the treatment of heart disease.

$15 Million Award In Birth Malpractice Case Hayward Baby Has Brain Damage
May 29, 2003 | San Francisco Chronicle A jury in Hayward has awarded nearly $15 million to the family of a 2- year-old boy who suffered permanent brain damage because of medical malpractice by Alameda Hospital and a doctor.

I’m glad to hear that Alameda Hospital Cardiac emergency care has improved recently. It certainly had room for improvement. About 10 years ago a neighbor of mine was taken in with chest pains and was indeed having a heart attack. He was sent home without having any studies to look at blocked veins, a common practice for heart patients in every other ER. When he had his second heart attack a few days later, he refused to be taken to Alameda Hospital and got the care he needed to identify and clear his blocked arteries.

When I recently experienced heart symptoms, I refused to be taken to Alameda Hospital. Why risk it? I’m glad US News and World Report thinks they’re grand – perhaps they’d like to receive their care at Alameda Hospital. Not me.

I just checked the Us News and World Report rankings. Standford is listed for cardiac care (#16), as is Alta Bates is too(not in the top 50, but somewhere among the other 550 entrants). ALAMEDA HOSPITAL IS NOT LISTED. So, Richard Hausman, how about some links that support the claims you’re making?

I’m standing by my decision to go to one of the top 600 hospitals for cardiac care – Alta Bates – rather than Alameda Hospital which isn’t even in the running. But, Richard, you go right ahead.

Regarding the cardiac unit, I was told by a doctor at Alameda Hospital that the reason Alameda Hospital gets this award is because they shuttle the patient via ambulance directly into the Alta Bates cardiac unit so that you have no waiting time to get into this excellent unit. However, if I tell the paramedics to take me directly to Alta Bates, I’d get assessed and directly into the cardiac unit as well, with only a single hospital visit, ambulance ride, and bill, not two of each. Stebbins is replicating this *successful* business strategy for stroke care as well. Paramedics are required by their protocols to take people to the nearest cardiac or stroke clinic; and I’m guessing that if Alameda Hospital says they have a cardiac and stroke clinic—even if Alameda Hospital is not approved for many cardiac and stroke procedures and therefore cannot treat serious cardiac and stroke victims–, then paramedics must take people to Alameda Hospital instead of Sutter or Alta Bates. Stebbins’ new strategy for the stoke clinic is to run stroke victims through Alameda Hospital then send them to Eden in Castro Valley. These strategies appear to be great for Alameda Hospital’s bottom line; not so much for Alameda’s residents! I have very real concerns about whether this is best for our health (how does heading directly to AB or Sutter compare?) and our pocketbooks—I don’t know about you all but two hospital bills in a single day is a financial hardship I’d like to avoid!

Oh, Richard. I worry about you. It seems likely you are receiving memory care at Alameda Hospital. What else would lead you to mistake the American Heart Association award as anything but a “now you’ve finally gotten with the program” award? It’s all about discharging heart patients and putting them on all the standard treatments, like this (from the alameda Hospital website):

“Under the Get With The Guidelines – CAD program, patients are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers in the hospital and receive smoking cessation/weight management counseling as well as referrals for cardiac rehabilitation before they are discharged. Hospitals that receive the Get With The Guidelines -CAD Gold Performance Achievement Award have demonstrated for 24 consecutive months that at least 85 percent of its eligible coronary patients (without contraindications) are discharged following the American Heart Association’s recommended treatment guidelines.”

Is there a credible hospital – or doctor – who doesn’t know this and do this as a matter of course? This is the hard part for me: It’s 2010 – very late in the day to be implementing protocols that have been industry standards for decades. This is an attendance award, a thanks for bringing up the rear award, not a performance award.

Here’s what US News and World Report has on Alameda Hospital: Lackluster customer service ratings. No awards, no listing as providing good cardiac care, in fact cardiac care isn’t listed as a service they provide. So, not a best hospital in the country, just one who completed the survey so they’d be listed in the healthcare issue.

Expect this kind of dribble from a SUNCAL BONTAM/EASY & CRAFTY supporter. No facts, only misstatements intended to misguide voters. Did SUNCAL cut you a check too? Are you on TAM’s private email list of 31? An out of town supporter of BONTA with a well financed checkbook?

Please give us at least the appearance of honesty, completeness even if you are completely disregarding what Alamedans want so that SUNCAL can suck our treasury dry.

I will get back to this, but for now: You have got to be kidding me. Is there supposed to be some other, perfect hospital out there which is always available? Anyone who has very elderly parents (or is elderly) would not want to see them shipped off to Kaiser or — god forbid — Highland.

Both my mother and my stepfather (who passed away last year at the age of 99), were hospitalized at Alameda in the ER, and as inpatients. I was very much appreciative of the good care, plus the kindess that they received from the staff. I’ve also been to the ER for minor injuriess, had to wait several hours for treatment, but I wasn’t the sickest person there.

I’ve seen the care at Kaiser-Oakland, both ER and inpatient — and it’s frighteningly bad. Just for starters, incoming ER patients have to stand in line at an intake desk, a long line. Inpatients with any kind of serious condition have to be watched over by friends and relatives, or they won’t get adequate care.

As for Highland ER, as a trauma center I imagine that it provides good care for critically injured people (?), but I’m guessing that anyone with a serious but not life threatening medical problem is going to sit and wait (and wait).

Is this some kind of bizarre campaign to discredit Rob Bonta? What has he got to do with it? This hospital was around long before Bonta was even born. And haven’t we had enough of bizarre PR campaigns in any event (as in “Ann Marie Gallant will destroy us all”, etc.)?

Tam, Bonta and Ashcraft are all touting their service on the Health Care District Board as part of their election campaign. As elected officials with oversight of the Hospital, they are ultimately responsible for what goes on there.

As usual, the conversation in Alameda digresses to a juvenile and hostile defensive/offensive which-side-are-you-on! politics unfounded in a factual discussion that will accurately characterize our conditions, identifying very real problems, idea-generate for solutions, and then optimizing their implementation. What us? Work together? No. It’s always got to be about egos and who’s puffery’s going to outdo the opponent. There are no opponents. We are all in this soup called City of Alameda together. Let’s collaborate intelligently for a better city.

People: there is a VERY REAL problem here in Alameda city at our local hospital. The fact that in one instance EVERY SINGLE TEAM failed simultaneously and almost killed someone means in all likelihood there is a systemic problem at the hospital. This could harm you or someone you know. Can we please discuss it???? We’re all–including the current and hospital board and city council members—capable of rigorous dialog. Let’s step up and really solve for our problems at hand!

A lot could be resolved if the Alameda Hospital and the V.A. could come together on some sort of shared facility. It may have to be at Alameda Point, re-locating the Hospital from it’s central-Alameda location, but it would obviate the need to spend the money to retro-fit the existing building.

Having the A.H. staff working closer with the V.A. staff might somehow bring about some changes/improvements in practices, and reduce the bad incidents reported here, and on the Facebook page (?)

Can’t imagine any of the doctors involved are going to risk a malpractice suit and go on record admitting to their mistakes.

Ms. Lai mentioned her experience with Alameda Hospital to us some months ago when it happened. She wanted to work through all the issues with the hospital, and work through her health issues, before going public with her story. We also spoke directly with another A.H. patient who had a similarly bad experience, but who is not willing to go on the record with their story.

The concerns about cardiac care at A.H. – that you just get re-directed off to another hospital – is something that we’ve heard anecdotally from others over the past couple of years now.

dim: there are very few situations for which the slightly extra time to get to Alta Bates would make any difference at all. what makes the difference is the standard of care, it’s what you want and expect at any hospital. If Alameda Hospital is—for whatever reason (business strategies, cost cutting, management and training failures)—unable to maintain minimum medical standards of care, then why would anyone want to go there? What’s another 3 to 5 minutes for most medical emergencies when you’re in an ambulance?

I’ve worked in healthcare for more than 30 years, consulted with 43 hospitals and clinics in the Greater Bay Area, and have been a patient at many of those hospitals myself. My life was saved by a clot-buster, but I was quickly transported to Alta-Bates for follow-up, a stent implant, and future care. I had my quad by-pass at Alta-Bates, performed by a surgeon I had worked with at Children’s Hospital Oakland, where I was PR Director for five years.

Hospital PR and the truth ain’t the same thing, of course. I think Alameda Hospital should be closed down. And that anyone who has served on its board should be suspect. But that’s just the beginning. I am now a Kaiser patient, and Kaiser Oakland Ninth Floor nurses should be re-examined by JCAH. Otherwise, they do a damn good job.

And when I went to Highland as a person without health insurance, with a badly broken leg from being run-down in a crosswalk, I got great and rapid care, so those are just a few personal testimonials, and condemnations. Most times I’m picked up by EMTs, I’m taken directly to Kaiser Oakland, and I know how to get a private exam room, and out of the hallway.

You have to be your own patient advocate, and lacking that, your chances of survival of a serious emergency, go way down!

Dennis: AGREED. However, how are we to know—in an emergency—the correct dosage for a narcotic and whether or not they are giving us a safe or a lethal dose? This is something a patient simply cannot know, or research on the fly, and be vigilant about unless the patient is already a doctor/nurse with this knowledge. And this is VERY BASIC medical knowledge and standards that EVERY nurse and doctor should know and should NEVER err on—and if a doctor does err, the nurse should know better and catch it. Yet at Alameda Hospital NEITHER nurse nor doctor did. This indicates a systemic or organizational cultural problem. I myself would never put myself or a family member at risk for this again. Neither would the head ER doctor at Alameda Hospital (they are a contracted workforce, btw) as he stated to Denise.